Comparison of upper extremity kinematics in children with spastic diplegic cerebral palsy using anterior and posterior walkers

Abstract This prospective study analyzes the upper extremity kinematics of 10 children with spastic diplegic cerebral palsy using anterior and posterior walkers. Although both types of walkers are commonly prescribed by clinicians, no quantitative data comparing the two in regards to upper extremity...

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Bibliographic Details
Published in:Gait & posture 2008-10, Vol.28 (3), p.412-419
Main Authors: Strifling, Kelly M.B, Lu, Na, Wang, Mei, Cao, Kevin, Ackman, Jeffrey D, Klein, John P, Schwab, Jeffrey P, Harris, Gerald F
Format: Article
Language:English
Subjects:
Adolescent
Biomechanical Phenomena
Cerebral palsy
Cerebral Palsy - physiopathology
Child
Child, Preschool
Elbow Joint - physiopathology
Energy Metabolism
Equipment Design
Female
Forearm - physiopathology
Gait
Humans
Kinematics
Male
Orthopedics
Prospective Studies
Range of Motion, Articular - physiology
Rotation
Upper extremity
Walker
Walkers
Wrist Joint - physiopathology
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Summary:Abstract This prospective study analyzes the upper extremity kinematics of 10 children with spastic diplegic cerebral palsy using anterior and posterior walkers. Although both types of walkers are commonly prescribed by clinicians, no quantitative data comparing the two in regards to upper extremity motion has been published. The study methodology included testing of each subject with both types of walkers in a motion analysis laboratory after an acclimation period of at least 1 month. Overall results showed that statistically, both walkers are relatively similar. With both anterior and posterior walkers, the shoulders were extended, elbows flexed, and wrists extended. Energy expenditure, walking speed and stride length was also similar with both walker types. Several differences were also noted although not statistically significant. Anterior torso tilt was reduced with the posterior walker and shoulder extension and elbow flexion were increased. Outcomes analysis indicated that differences in upper extremity torso and joint motion were not dependent on spasticity or hand dominance. These findings may help to build an understanding of upper extremity motion in walker-assisted gait and potentially to improve walker prescription.
ISSN:0966-6362
1879-2219
DOI:10.1016/j.gaitpost.2008.01.018